Miller M, Bachorik P S, McCrindle B W, Kwiterovich P O
Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Am J Med. 1993 Jan;94(1):7-12. doi: 10.1016/0002-9343(93)90113-4.
To evaluate the efficacy of gemfibrozil in men with primary isolated low high-density lipoprotein cholesterol (HDL-C) levels.
Fourteen men with low levels of HDL-C but desirable total cholesterol levels received gemfibrozil in a randomized, double-blind, placebo-controlled, crossover trial. The men were placed on a National Cholesterol Education Program Step-Two Diet. They were randomly assigned to receive placebo and gemfibrozil each for 3 months, with a 1-month washout period between phases.
Overall, gemfibrozil increased the total HDL-C concentration by 9.2% (p = 0.001), reduced triglyceride (TG) levels by 38% (p < 0.01), and significantly lowered the total cholesterol:HDL-C ratio (p = 0.01). Those with fasting TG levels of 1.07 mmol/L (95 mg/dL) or greater had a significant elevation in the HDL-C level (14.6%, p = 0.005) and a reduction in TG levels (50%, p = 0.002) with gemfibrozil; those with fasting TG levels less than 1.07 mmol/L had a smaller increase in the HDL-C level (4.1%, p > 0.05) and a smaller reduction in TG levels (15%, p = 0.02). There were no significant differences in the plasma levels of low density lipoprotein-cholesterol, HDL2-C, apolipoproteins (apo) A-I and B, or Lp(a). HDL3-C and apo A-II levels rose slightly. The adverse effects attributable to gemfibrozil were minimal.
In men with desirable total cholesterol levels, gemfibrozil raises HDL-C and lowers TG levels to a similar extent as reported for hyperlipidemic men in the Helsinki Heart Study. These lipid-altering effects were most pronounced in those with the highest fasting TG levels.
评估吉非贝齐对原发性单纯高密度脂蛋白胆固醇（HDL-C）水平低的男性患者的疗效。
14名HDL-C水平低但总胆固醇水平正常的男性患者参与了一项随机、双盲、安慰剂对照、交叉试验，接受吉非贝齐治疗。这些男性遵循国家胆固醇教育计划第二步饮食方案。他们被随机分配，分别接受3个月的安慰剂和吉非贝齐治疗，两阶段之间有1个月的洗脱期。
总体而言，吉非贝齐使HDL-C总浓度升高了9.2%（p = 0.001），甘油三酯（TG）水平降低了38%（p < 0.01），并显著降低了总胆固醇与HDL-C的比值（p = 0.01）。空腹TG水平为1.07 mmol/L（95 mg/dL）或更高的患者，使用吉非贝齐后HDL-C水平显著升高（14.6%，p = 0.005），TG水平降低（50%，p = 0.002）；空腹TG水平低于1.07 mmol/L的患者，HDL-C水平升高幅度较小（4.1%，p > 0.05），TG水平降低幅度较小（15%，p = 0.02）。低密度脂蛋白胆固醇、HDL2-C、载脂蛋白（apo）A-I和B或脂蛋白（a）的血浆水平无显著差异。HDL3-C和apo A-II水平略有升高。吉非贝齐引起的不良反应极小。
在总胆固醇水平正常的男性中，吉非贝齐升高HDL-C和降低TG水平的程度与赫尔辛基心脏研究中高脂血症男性的报告相似。这些血脂改变作用在空腹TG水平最高的患者中最为明显。
